Scoping review of addressing violence against children and adolescents in the context of primary health care: a necessary qualitative approach

Abstract

This study presents a possible qualitative analysis within the scope review about the key concepts most sensitive to confront domestic violence against children and adolescents. This is part of a larger systematic review study. The authors have discussed the difficulty of health services in identifying and accommodating the health needs created by the phenomenon of violence (Egry, Apostolico & Morais, 2018; Apostolico, Nóbrega, Guedes, Fonseca & Egry, 2012). This difficulty can be explained by the existence of policies and strategies based on the classical epidemiology, followed by a market-driven health ideas and a care based on the detail and medical centrality (Mendes, 2015; Breilh, 2014). Therefore, they neither provide conditions, capacity, nor governability over all determinations of violence, and they do not always respond to all the health needs of children and adolescents in violence’s conditions. This shows the need for a critical-hermeneutic reflection on the key concepts that support the elaboration of policies and strategies to cope with domestic violence against children and adolescents. Objective: to demonstrate ways to synthesize the key concepts existent in the plans, projects and actions which support the confrontation of violence against children and adolescents in the primary health care setting. Methodology: This is an analytical demonstration of a Systematic Scope Review. In the present study, this method allowed the qualitative approach to map the key concepts and to define conceptual boundaries. The methodological procedures followed the recommendations of the Joanna Briggs Institute with the guideline question being “What are the plans, projects, and actions that facilitate or support strategies to fight violence against children and teenagers within the primary health care scope of practice?”. The articles selected were published in English, Spanish and Portuguese, regardless of the publishing date, in 14 databases in several areas of knowledge. We adopted the theoretical bases of Nursing in Collective Health and its respective analytical categories with special emphasis in the categories of gender and generation. We used the webQDA qualitative analysis software. Critical hermeneutics was used for the synthesis. Results: Out the 987 citations found, 37 were included in the review in which 15 articles were Latin American, nine North American and 13 European. The main key concepts were: multi professional and inter sectoral work; routing; work process; promotion; identification and family. These concepts are contradictory, at the same time as they are shown as the pillars for policies and strategies. They also appear as limitations that needs to be overcome. The worldview that is the foundation of policies and strategies provides a fragmented view of the health-disease process; therefore, the key map concepts failed to perform the synthesis for totalizing the intervention in practice. Conclusion: This review allowed the identification, synthesis and the critical reflection of the key concepts that are sensitive to the confrontation of violence in different countries, circumstances and health institutions, under a theoretical framework that includes the factors of the violence phenomenon. This may promote new forms of professional qualification and contribute to the formulation of policies and strategies.